Preventable multiple high-risk birth behaviour and infant survival in Nigeria

Abstract Background Globally, infant mortality has declined considerably but has remained unacceptably high in sub-Saharan Africa, especially Nigeria where infant mortality rate is 67/1000 live births. To facilitate infant mortality reduction in Nigeria, an understanding of the synergistic effect of bio-demographic characteristics of mothers known as High Risk Birth Behaviours (HrBBs) is important. We therefore investigated the influence of HrBBs on infant survival in Nigeria. Methods This cross-sectional study design utilized data from the 2018 round of Nigerian Demographic Health Survey. The study participants were a representative sample of women of reproductive age (n = 21,350) who had given birth within the 5 years preceding the survey. HrBBs was measured through integration of information on maternal age at child’s birth, parity, and preceding birth interval with respect to the most recent child. The HrBBs was categorized as none, single and multiple. Data were analysed using descriptive statistics, Log-rank test and Cox proportional hazard model (α =0.05). Results The mean age of the women was 29.7 ± 7.2 and 4.1% had experienced infant death. Infant mortality was highest among women with multiple HrBBs (5.1%). Being a male, having small size at birth, failure to receive tetanus injection, non-use of contraceptives and living in the core-north (North West and North East) predisposed children to higher risk of dying before 12 months of age. The hazard ratio of infant mortality was significantly higher among infants of mothers in multiple HrBBs category (aHR = 1.66; CI: 1.33–2.06) compared to their counterparts with no HrBBs. Conclusion Multiple HrBBs increase the chances of dying among infants in Nigeria. Screening women for HrBBs for special health attention during pregnancy, birth and postnatal period will alleviate infant death in Nigeria.

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Preventable Multiple High-Risk Birth Behaviour and Infant Survival in Nigeria

10.21203/rs.3.rs-99092/v1 ◽

2020 ◽

Author(s):

Mobolaji Modinat Salawu ◽

Rotimi Felix Afolabi ◽

Babatunde Makinde Gbadebo ◽

Adetokunbo Taophic Salawu ◽

Adeniyi Francis Fagbamigbe ◽

...

Keyword(s):

High Risk ◽

Infant Mortality ◽

Infant Death ◽

Reproductive Age ◽

Infant Mortality Rate ◽

Sub Saharan Africa ◽

Rank Test ◽

Infant Survival ◽

Cross Sectional ◽

North East

Abstract Background Globally, infant mortality has reduced considerably but has remained unacceptably high in sub-Saharan Africa, especially Nigeria where infant mortality rate is 67/1000 live births. To facilitate infant mortality reduction in Nigeria, an understanding of the synergistic effect of bio-demographic characteristics of mothers known as High Risk Birth Behaviours (HrBBs) is important. We therefore investigated the influence of HrBBs on infant survival in Nigeria.MethodsThis cross-sectional study design utilized data from the 2018 round of Nigerian Demographic Health Survey. The study participants were a representative sample of women of reproductive age (n=21350) who had given birth within the 5 years preceding the survey. HrBBs was measured through integration of information on maternal age at child’s birth, parity, and preceding birth interval with respect to the most recent child. The HrBBs was categorized as none, single and multiple. Data were analysed using descriptive statistics, Log-rank test and Cox proportional hazard model (α =0.05). Results The mean age of the women was 29.7 ± 7.2 and 4.1% had experienced infant death. Infant mortality was highest among women with multiple HrBBs (5.1%). Being a male, having small size at birth, failure to receive tetanus injection, non-use of contraceptives and living in the core-north (North West and North East) predisposed children to higher risk of dying before 12 months of age. The hazard ratio of infant mortality was significantly higher among infants of mothers in multiple HrBBs category (aHR=1.67; CI: 1.33-2.09) compared to their counterparts with no HrBBs. Conclusion Multiple HrBBs increase the chances of dying among infants in Nigeria. Screening women for HrBBs for special health attention during pregnancy, birth and postnatal period will alleviate infant death in Nigeria.

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SOCIODEMOGRAPHIC FACTOR RELATIONSHIP WITH INFANT SURVIVAL IN INDONESIA

Jurnal Biometrika dan Kependudukan ◽

10.20473/jbk.v10i1.2021.11-17 ◽

2021 ◽

Vol 10 (1) ◽

pp. 11

Author(s):

Yasmine Nurfirdaus ◽

Philip Etabee Macdonald Bassey

Keyword(s):

Mortality Rate ◽

Infant Mortality ◽

Child Survival ◽

Infant Mortality Rate ◽

Infant Survival ◽

Chi Square ◽

Cross Sectional ◽

Live Births ◽

Bivariable Analysis ◽

Chi Square Analysis

Child survival can be reflected in the presence of the Infant Mortality Rate (IMR). Indonesia has an Infant Mortality Rate (IMR) according to the 2017 IDHS, which reaches 24 deaths per 1000 live births. This figure has decreased compared to a survey conducted by the 2012 IDHS, where infant mortality reached 32 deaths per 1000 live births. Even though it experienced a decrease, the IMR in Indonesia was higher when compared to the IMR in other Southeast Asian countries. Socioeconomic factors for individuals, families, and communities, including the influence of infant mortality. Not only that, but infant mortality can also be due to the absence of awareness of maternal health. Thus, this study aims to determine several variables related to survival in infants in Indonesia. This type of research is a non-reactive study. This study uses quantitative analysis and a methodical approach with a cross-sectional approach that takes data from the 2017 IDHS. This study took a sample following the 2017 IDHS with the criteria that mothers who had babies still drank breast milk, were born single, and were still alive after the first three days in Indonesia. The number of respondents in this study was 7,599 mothers with babies. Analysis of the research data using Chi-Square analysis. Bivariable analysis shows that infants' survival has a relationship with the mother's education, type of area, and welfare level. However, infant survival also has no association with the age of the mother and birth attendants. Counseling pregnant women regarding risks, causes,

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Revisit the correlates of infant mortality in Bangladesh: findings from two nationwide cross-sectional studies

BMJ Open ◽

10.1136/bmjopen-2020-045506 ◽

2021 ◽

Vol 11 (8) ◽

pp. e045506

Author(s):

Md Mahabubur Rahman ◽

Tasnim Ara ◽

Sultan Mahmud ◽

Nandeeta Samad

Keyword(s):

Risk Factors ◽

Infant Mortality ◽

Potential Risk ◽

Infant Death ◽

Rural Areas ◽

Urban Areas ◽

Employment Status ◽

Higher Order ◽

Infant Survival ◽

Cross Sectional

ObjectiveThe main objective of this study is to investigate how the direction and strength of the association between infant mortality and its predictors are changing over time in Bangladesh using a nationally representative sample for the period 2011–2014.Design, setting and participantsData from two repeatedly cross-sectional Bangladesh Demographic and Health Surveys (BDHSs) for the years 2011 and 2014 were used. A total of 7664 (with 312 infant death) and 7048 (with 264 infant death) complete cases, respectively, from BDHS 2011 and 2014 datasets were included in the study.MethodsCox’s proportional hazard model with robust standard error (SE) that adjusts for the complex survey design characteristics was implemented to assess how the risk factors associated with infant mortality change their paths.ResultsResults reflected that administrative division remained as a potential risk factor of infant death for both periods. Household’s socioeconomic status, father’s employment status, age difference between parents turned out to be potential risk factors in 2014, though they did not show any significant association with infant death in the year 2011. In contrast to 2011, mothers’ individual-level characteristics such as age at childbirth, education, media exposure, employment status did not remain as significant risk factors for infant death in 2014. Younger fathers increased the burden of death among infants of adolescent mothers. At higher order births, the burden of infant death significantly shifted from rural to urban areas. From the year 2011 to 2014, urban areas achieved socioeconomic equity in infant survival, while the extent of inequity was increased in rural areas.ConclusionCommunity-based programmes should be designed for urban mothers who are expecting higher order births. To eradicate the socioeconomic inequity in infant survival, the government should design strong and sustainable maternal and child healthcare facilities, especially for rural areas.

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Prevalence of High Risk HPV in HIV-Infected Women From Belém, Pará, Amazon Region of Brazil: A Cross-Sectional Study

Frontiers in Public Health ◽

10.3389/fpubh.2021.649152 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jacqueline Cortinhas Monteiro ◽

Ricardo Roberto de Souza Fonseca ◽

Tuane Carolina de Sousa Ferreira ◽

Luana Lorena Silva Rodrigues ◽

Andreza Reis Brasil da Silva ◽

...

Keyword(s):

Cervical Cancer ◽

High Risk ◽

Hpv Infection ◽

Cross Sectional Study ◽

Reproductive Age ◽

Transmitted Infection ◽

Cross Sectional ◽

Multiple Sexual Partners ◽

Sexually Transmitted ◽

High Risk Hpv

Human papillomavirus (HPV) is the most common sexually transmitted infection in the world. Several studies have shown a higher prevalence of HPV infection in HIV-infected women. The aim of this study was to determine the prevalence and the genotype diversity of HPV infection in HIV-infected women. From April 2010 to December 2012 cervical specimens were collected from 169 HIV-infected women who screening for cervical cancer at Reference Unit in Belém. The detection of HPV infection was performed by nested PCR and HPV type was performed using a commercial system. The prevalence of HPV infection was 63.3%. Of the 47 genotyped samples, 40.4% was found positive for high risk-HPV 16 and 12.8% for high risk-HPV 52. HPV infection was predominant in the group of women with no incidence of cytological abnormalities and more prevalent in women of reproductive age, unmarried, low education level, and who reported use condoms during sexual intercourse. It was observed an association between HPV infection and independent variables, such as condom use, multiple sexual partners, and history of sexually transmitted diseases. High-risk types of HPV infection were prevalent in our study. Infection with multiple high-risk HPV genotypes may potentiate the development of cervical cancer in HIV-infected women.

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Stillbirth and infant death: mental health among low-income mothers in Mumbai

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03754-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lisa Roberts ◽

Solomon J. Renati ◽

Shreeletha Solomon ◽

Susanne Montgomery

Keyword(s):

Mental Health ◽

At Risk ◽

Low Income ◽

Infant Death ◽

Postnatal Depression ◽

Perinatal Loss ◽

Reproductive Age ◽

Cross Sectional ◽

History Of ◽

Perinatal Grief

Abstract Background India has the highest number of stillbirths and the highest neonatal death rate in the world. In the context of its pronatalist society, women who experience perinatal loss often encounter significant social repercussions on top of grief. Furthermore, even when pregnancy outcomes were favorable, adverse life circumstances put some women at risk for postnatal depression. Therefore, perinatal loss and postnatal depression take a heavy toll on women’s mental health. The purpose of this study is to assess mental health among a sample of Mumbai slum-dwelling women with a history of recent childbirth, stillbirth, or infant death, who are at risk for perinatal grief, postnatal depression, or mental health sequelae. Methods We conducted a mixed method, cross-sectional study. A focus group discussion informed the development of a comprehensive survey using mainly internationally validated scales. After rigorous forward and back-translation, surveys were administered as face-to-face structured interviews due to low literacy and research naiveté among our respondents. Interviews were conducted by culturally, linguistically, gender-matched, trained research assistants. Results Of our reproductive age (N = 260) participants, 105 had experienced stillbirth, 69 had a history of infant death, and 25 had experienced both types of loss. Nearly half of the sample met criteria for postnatal depression, and 20% of these women also met criteria for perinatal grief. Anxiety and depression varied by subgroup, and was highest among women desiring an intervention. Conclusions Understanding factors contributing to women’s suffering related to reproductive challenges in this pronatalist context is critically important for women’s wellbeing.

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PEMILIHAN KONTRASEPSI BERDASARKAN EFEK SAMPING PADA DUA KELOMPOK USIA REPRODUKSI

Unnes Journal of Public Health ◽

10.15294/ujph.v6i3.11543 ◽

2017 ◽

Vol 6 (3) ◽

pp. 167

Author(s):

Erna Setiawati ◽

Oktia Woro Kasmini Handayani ◽

Asih Kuswardinah

Keyword(s):

Side Effects ◽

High Risk ◽

Random Sampling ◽

High Risk Pregnancy ◽

Reproductive Age ◽

Cross Sectional ◽

Whitney Test ◽

Mann Whitney Test ◽

Risk Pregnancy

ABSTRACT Kelompok usia reproduksi terbagi dalam tiga fase yaitufase menunda kehamilan (<20 tahun), fase menjarangkan kehamilan (20-30 tahun) dan fase mengakhiri kehamilan (>30 tahun). Cara yang ditempuh yaitu dengan pemakaian kontrasepsi.baik MKJPmaupunnon MKJP. Tujuan penelitian ini adalah untuk mengetahui ada atau tidak perbedaan pemilihan kontrasepsi MKJP dan non MKJP berdasarkan efek samping pada dua kelompok usia reproduksi. Penelitin ini menggunakan desain cross sectional, pengambilan data dengan kuesioner. Sampel dalam penelitian ini adalah akseptor KB baik MKJP maupun non MKJP pada bulan april sampai juni sebanyak 200 responden, dimana tekhnik pengambilan datanya dengan random sampling dan kuota sampling. Hasil penelitian kemudian diuji dengan mann-whitney test.Hasil penelitian dengan uji mann whitney test diperoleh p = 0.662 dengan kata lain p > α (0.05) yang berarti tidak ada perbedaan pemilihan MKJP dan non MKJP berdasarkan efek samping di Wilayah Kabupaten Semarang. ABSTRACT Reproductive-age category can be divided into three groups which are the group of delayed interval pregnancy (less than 20 years old), the group of intervalcontrol pregnancy (20 to 30 years old), and the group of high risk pregnancy (more than 30 years old). An alternative to avoid high risk pregnancy is by using contraception tool namely long-term contraception (MKJP) and non long-term contraception (non MKJP).The purpose of this research is to analysedwhether there are differences in choosing MKJP and non –MKJP based on side effects in the two reproductive-age groups.This research was an explanatory research with cross-sectional design. The population were all women of contraception acceptors in Semarang Regency.The samples were 200 respondents, used simple random sampling and quota sampling. This research used quisionaire instrument and analyze used mann whitney test (α=0,05). Theresult showed thatP = 0,662 meaning P > α = 0.05 which means there is no difference in choosing MKJP and non-MKJP based on side effects in the two reproduction-age groups in Semarang regency.

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Association Between Maternal High-risk Fertility Behavior and Pregnancy Intention Among Women Aged 15 to 49 in Rwanda: Analysis of the 2014-15 Rwanda Demographic and Health Survey

10.21203/rs.3.rs-779814/v1 ◽

2021 ◽

Author(s):

Aurore Nishimwe ◽

Philomene Uwimana ◽

Liberee Rumagihwa ◽

Alfred Rutagengwa ◽

Laetitia Nyirazinyoye ◽

...

Keyword(s):

High Risk ◽

Unintended Pregnancy ◽

Health Survey ◽

Secondary Data ◽

Cross Sectional Study ◽

Pregnancy Intention ◽

Fertility Behavior ◽

Demographic And Health Survey ◽

Reproductive Age ◽

Cross Sectional

Abstract Background: Maternal high-risk fertility behaviors have been linked to negative maternal and child health outcomes that include anaemia, undernutrition, and child mortality. In this context, we examined the association between maternal high-risk fertility behavior and pregnancy intention among women of reproductive age in Rwanda.Methods: This cross-sectional study is based on secondary data from the 2014–15 Rwanda Demographic and Health Survey (n=5661). The outcome of interest was pregnancy intention of the last child defined as intended or unintended. Maternal high-risk fertility behaviors were measured using maternal age at delivery, birth order, and birth interval. Chi-square test and multivariable regression models were performed. Results: The prevalence of unintended pregnancy was 46.8% (n=2652). Overall, 35.8% (n=2017) of women experienced single high-risk fertility behavior, while 23.1% (n=1282) of women experienced multiple high-risk fertility behaviors. Compared to women who have not experienced high-risk fertility behavior, the multivariable odds ratio (95% CI) of unintended pregnancy among women in single-risk and multiple-risk fertility behaviors were 2.00 (1.75, 2.28; p <0.001) and 2.49 (2.09, 2.95; p <0. 001.), respectively.Conclusion: Exposure to high-risk fertility behaviors is positively associated with unintended pregnancy among women in Rwanda. Therefore, reproductive and sexual health services should pay special attention to women who are <18 years or >34 years old; who have more than three children already; or have children with less than 24 months’ interval between giving birth.

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Decomposing the Effect of Women Educational Status on Fertility Across the Six Geo-political Zones in Nigeria: 2003-2018

10.21203/rs.3.rs-51297/v1 ◽

2020 ◽

Author(s):

Tubosun Alex Olowolafe

Keyword(s):

Educational Status ◽

Fertility Rate ◽

Reproductive Age ◽

High Fertility ◽

Age At First Birth ◽

Fertility Level ◽

Cross Sectional ◽

North East ◽

Fertility Variation ◽

Fertility Differentials

Abstract Background: High level of fertility has been consistently reported in Nigeria. Women education is often identified as one of the important factors that have contributed to reduction in fertility across countries. It is essential to identify the factors that explain the fertility variation in educational status and know the extent of association of these factors across the regions in Nigeria. Thus, this study aimed to examine the fertility differentials among uneducated and educated women in Nigeria.Methods: A cross-sectional population-based design which involved secondary data analyses of the weighted sample of 2003 (n1=7620), 2008 (n2=33385), 2013 (n3=38948) and 2018 (n4=41821) Nigeria Demographic and Health Survey data sets was used. Fertility was measured from information on the full births history of women aged 15-49 years. Oaxaca-Blinder decomposition was used to identify factors that explain fertility differentials among educated and not educate women (α=0.05).Result: Total fertility rate estimate was higher among uneducated women (6.7) than educated women (4.5) in 2018. The pattern was similar across the regions and survey periods. The mean children ever born among women aged 45-49 years was significantly higher among the uneducated than educated women in each of the survey year. Maternal age at first marriage, wealth index and age at first birth were contributory factors to the dissimilarities found in fertility between the educated and uneducated women. Risk difference (RD) of high fertility between uneducated-educated women was highest in South-East (RD=56.9; 95%CI=49.1-64.8) and least in North-East (RD=15.0; 95%CI=9.9-20.1).Conclusion: The fertility level in Nigeria was high but more prominent among the uneducated than educated. Improving the level of educational enrolment of women of reproductive age will facilitate reduction in the fertility rate in Nigeria.

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1671. Impact of Zika Syndrome on Brazilian Infant Mortality Rate

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1535 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S611-S612

Author(s):

Nilson Nogueira Mendes Neto ◽

Jessika T da S. Maia ◽

Marcelo Zacarkim ◽

Igor T Queiroz ◽

Gleyson Rosa ◽

...

Keyword(s):

Infant Mortality ◽

Zika Virus ◽

Case Fatality ◽

Health Department ◽

Perinatal Period ◽

Cross Sectional Study ◽

Infant Mortality Rate ◽

Cross Sectional ◽

Using Data ◽

Serological Data

Abstract Background Infant mortality in Brazil has increased for the first time in 26 years. This study aimed to define the Zika Syndrome (ZS) perinatal case fatality rate (PCF) since the 2015 Zika outbreak in a Brazilian northeast state highly impacted by the virus. Methods Cross-sectional study conducted using data obtained through the State Health Department for cases of microcephaly (MCP) and congenital abnormalities (CA) in Rio Grande do Norte State (RN) from April 2015 to March 2, 2019. Perinatal period: commencing at 22 completed weeks (154 days) of gestation until 7 days after birth. PCF was defined as the number of deaths as a fraction of the number of sick persons with the specific disease (×100). Results There were 535 reported cases of MCP and others CA notified in RN during this period: 4 in 2014, 337 in 2015, 157 in 2016, 21 in 2017, 14 in 2018, and 2 in 2019. Of these, 151 were confirmed and 135 remain under investigation. The remaining 247 cases were ruled out by normal physical exams or due to noninfectious cause of MCP. Of the total confirmed cases, 35.8% (54/151) died after birth or during pregnancy. Zika virus infection during pregnancy was confirmed in 55.5% (30/54) of deaths and 1.8% (01/54) had a positive TORCH blood test. The odds ratio for the Zika PCF was found to be 1.57 (95% CI: 0.7940–3.1398; P = 0.1928). Deaths related to Zika were confirmed using a combination of clinical and epidemiological findings paired with either radiological information or molecular/serological data (RT–PCR and/or IgM/IgG antibodies against Zika). Twelve cases remain under investigation and 7 were ruled out as MCP. The highest number of confirmed MCP cases occurred between August 2015 and February 2016. The prevalence increased in September, with a peak in November 2015 (20.1 cases per 1,000 live births). Conclusion Before the recent Brazilian Zika outbreak, the incidence of MCP in RN between 2010 and 2014 was 1.8 cases/year. The real incidence and prevalence might be higher due to the underreporting and lack of resources for confirmatory diagnostic tests (laboratory and imaging). This study indicates that Zika virus accounted for a substantial proportion of MCP cases seen during the years studied, and suggests that ZS contributed to an increase in infant mortality in Brazil. Disclosures All authors: No reported disclosures.

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MATERNAL HEALTH-SEEKING BEHAVIOUR AND UNDER-FIVE MORTALITY IN ZIMBABWE

Journal of Biosocial Science ◽

10.1017/s0021932016000298 ◽

2016 ◽

Vol 49 (3) ◽

pp. 408-421 ◽

Cited By ~ 1

Author(s):

Nyasha Chadoka-Mutanda ◽

Clifford O. Odimegwu

Keyword(s):

Public Health ◽

Maternal Health ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Health Seeking Behaviour ◽

Health Seeking ◽

Cross Sectional ◽

Under Five ◽

Sub Saharan ◽

Cox Proportional Hazard Regression

SummaryUnder-five mortality remains a major public health challenge in sub-Saharan Africa. Zimbabwe is one of the countries in the region that failed to achieve Millennium Developmental Goal 4 in 2015. The objective of this study was to examine the extent to which maternal health-seeking behaviour prior to and during pregnancy and post-delivery influences the likelihood of under-five mortality among Zimbabwean children. The study was cross-sectional and data were extracted from the 2010/11 Zimbabwe Demographic and Health Survey (ZDHS). The study sample comprised 5155 children who were born five years preceding the 2010/11 ZDHS to a sample of 4128 women of reproductive age (15–49 years). Cox Proportional Hazard regression modelling was used to examine the relationship between maternal health-seeking behaviour and under-five mortality. The results showed that maternal health-seeking behaviour factors are associated with the risk of dying during childhood. Children born to mothers who had ever used contraceptives (HR: 0.38, CI 0.28–0.51) had a lower risk of dying during childhood compared with children born to mothers who had never used any contraceptive method. The risk of under-five mortality among children who had a postnatal check-up within two months after birth (HR: 0.36, CI 0.23–0.56) was lower than that of children who did not receive postnatal care. Small birth size (HR: 1.70, CI 1.20–2.41) and higher birth order (2+) increased the risk of under-five mortality. Good maternal health-seeking behaviour practices at the three critical stages around childbirth have the potential to reduce under-five mortality. Therefore, public health programmes should focus on influencing health-seeking behaviour among women and removing obstacles to effective maternal health-seeking behaviour in Zimbabwe.

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